Golden ratio stack of spirals for flexible angiographic imaging: Proof of concept in congenital heart disease

PURPOSE: In this study, a golden ratio stack of spiral (GRASS) sequence that used both golden step and golden angle ordering was implemented. The aim was to demonstrate that GRASS acquisitions could be flexibly reconstructed as both cardiac-gated and time-resolved angiograms. METHODS: Image quality of time-resolved and cardiac-gated reconstructions of the GRASS sequence were compared to 3 conventional stack of spirals (SoS) acquisitions in an in silico model. In 10 patients, the GRASS sequence was compared to conventional breath hold angiography (BH-MRA) in terms of image quality and for vessel measurement. Vessel measurements were also compared to cine images. RESULTS: In the cardiac-gated in silico model, the image quality of GRASS was superior to regular and golden-angle with regular step SoS approaches. In the time-resolved model, GRASS image quality was comparable to the golden-angle with regular step technique and superior to regular SoS acquisitions. In patients, there was no difference in qualitative image scores between GRASS and BH-MRA, but SNR was lower. There was good agreement in vessel measurements between the GRASS reconstructions and conventional MR techniques (BH-MRA: 29.8 ± 5.6 mm, time-resolved GRASS-MRA: 29.9 ± 5.4 mm, SSFP diastolic: 29.4 ± 5.8 mm, cardiac-gated GRASS-MRA diastolic: 29.5 ± 5.5 mm, P > 0.87). CONCLUSION: We have demonstrated that the GRASS acquisition enables flexible reconstruction of the same raw data as both time-resolved and cardiac-gated volumes. This may enable better interrogation of anatomy in congenital heart disease.